The Indian Country Metabolic Wellness ECHO will support clinicians and interdisciplinary teams serving American Indian and Alaska Native communities in providing evidence-based, culturally grounded, and accessible care for people living with obesity, substance use disorders, inflammatory diseases, and related metabolic disease. Obesity will be addressed as a chronic, complex, and treatable disease that amplifies morbidity across multiple other disease states, including the syndemic of HIV, sexually transmitted infections, viral hepatitis, and substance use.  Food as medicine, including the role of first foods and traditional medicine in metabolic health and wellness, will also be shared.

The program will offer a free ECHO learning collaborative stewarded by clinical and community experts in metabolic health and food as medicine.  Learning via cases and didactics will focus on practical assessment and treatment, including nutrition, physical activity, behavioral care, anti-obesity medications, metabolic and bariatric surgery, and management of obesity-related complications. It will also address historical trauma, food and nutrition insecurity, rurality, medication affordability, specialty care access, and other structural determinants affecting Native communities. The sessions will take place virtually on Zoom the first Thursday of every month at 12pm PT, starting February 4^th, 2026.

What topics will be covered?

• Obesity as a chronic, relapsing disease influenced by biological, psychological, social, environmental, historical, and structural factors
• Respectful, person-centered, non-stigmatizing approaches to discuss weight, metabolic health, and treatment preferences
• Comprehensive obesity assessments, including weight history, medication review, metabolic complications, sleep, mental health, substance use, function, food access, and social determinants
• Individualized treatment plans incorporating nutrition, traditional foods, physical activity, sleep, behavioral interventions, pharmacotherapy, and metabolic or bariatric surgery when appropriate
• How to select, initiate, titrate, monitor, and discontinue anti-obesity medications based on evidence, comorbidities, contraindications, patient preferences, access, and treatment response
• Interactions among obesity, diabetes, cardiovascular and kidney disease, MASLD/MASH, HIV, hepatitis C, psychiatric treatment, trauma, and substance use disorders
• Integrating locally relevant traditional foods, foodways, and community resources into evidence-based care when desired by the patient and guided by appropriate Tribal experts
• Medication access barriers and collaborate across medical, pharmacy, nutrition, behavioral, social, and community-based services.